Response shift was found to be nondifferential across groups and was therefore ruled out as an explanation for why the case management intervention showed no impact on patients' perceptions of their health. The results of a then-test did not show differential recalibration overtime. Factor analysis did not support reconceptualization response shift in either group but did find weak evidence for reprioritization response shift. An analysis of residuals indicated that approximately 50% of study subjects in each group experienced response shift that is probably close to reconceptualization.